1250 TBlame QUACKERY IN THE PAST. [Y 27, 1911. dhesions which impede-free play of the tendon. The arm must now be abducted fioly, -with the: external QUACKERY IN THE PAST. condyle uppermost, whilst the operator's left hand pushes I against and resists rotation of the scapula tuntil the a.dhesions yield with their characteristic tear; the arm IN an essay on quackery there is a question that meets should then be quickly rotated outwards and carried one on the'threshold. What is a quack? Taking, like the upwards and to the front. These movements, if properly lawyers, Johnson's Dictionary as our authority for tbh carried out, are sufficient to rupture any adhesions definition of the-word, we finzd a quack there described I bat may exist in or around the joint, and provided no as " a boastful pretender to arts which he does not under- ut dae violence has been used, no inflammation will ensue. stand," or with a more direct application to the art of Pain, however, will be present to a certain extent, but healing as "a vain boastful pretender to physick; one even when severe no apprehension need be felt. Within who proclaims his own medical abilities in publick an hour or so of the operation the shoulder should be places." A further definition given by him is " An gently rubbed and moved. Tbis, if carefully done, will artful tricking practitioner in physick." From this we greatly relieve the pain,, and rarely will any local- applica- see that the great lex2icographer made a clear distinction tion be necessary. Rubbing and movement must be con- between pretenders to knowledge which they do not tinued daily, and on no account should the arm be slung possess and those who use knowledge in an artful and or kept immobile. Within a few days exercises, prefer- tricky, manner-in short, between the unqualified and the ably by means of weights and pulleys, should be com- qualified quack. Sir William Broadbent suggested that menCed, to restore the inevitably wasted and contracted this difference should be expressed by applying the muscle1.=s. word " cbarlatan" to medical men who use dishonour- In addition to the measures detailed above, considerable able methods in their, practice. This seems to us assistance- can be obtained in suitable cases by theuse of a mere artlficial distinct.ion. Randle Cotgrave in' what has been called intensive irradiation, and the wave his Dictionarie of the French and English 'Tongue, current applied from'a static machine. Intensive irradia. which is recognized by French as well As Ezglish tion is obtained by submitting the part to be treated to the scholars as authoritative, translated the- word char- rays of a 500 candle-power lamp with two reflectors, one latan as follows: "A mountebanke, a cousening drug- corrugated and the other conical, projecting lines of seller, a pratling quack salver, a tatler, babler, foolish' radiation, some of which are parallel and some crosswise. prater or comnimender of trifles." Skeat in his Etynwlogical By this means two parallel fields of great illumination are Dictionary of the Englih Language gives as the meaning' obtained, and the result of the application of this intensive of quack "to cry up pretended nostrums," and says it is irradiation is to induee a general relaxation of tissues with' only-a particular use of the original word, which he ex-' consequent relief of preesure and pain. In. acees thus plaims as " to make a noise like a duck.", He adds that tr ated istasis in the injured parts is promptly dealt with "quack-salver" is a derivative which ieans "a quack adpain is alleviated. who puffs up his salves or oin-tments 'the place of this The wave current is especially valuable in removing was later taken by " quack doctor." The waid, therefore, passive congestions by restoring the metabolic equilibrium originally meant a mountebank who ld salves, eye which is disturbed in the class of case-alludedto in this lotions, and so fortb, at fairs, like the quack depicted with article. It is interesting to note that the explanation given such realistic detail by Gerhard Douw in thb well-known of the relief of the pain in this way is that the nutrition picture which is reproduced in the plate facibg p. 1224; but of the parts affected by effusion is rectified. already in Johnson'sday ithad acquiredalargerconnotation. In dealing with painful conditions of the shoulder it is It is, unfortuhately, too true 'that many who are in a usefdtl to remember that at the point where the cir- technical sense within' the sanctuary profane their own cuomflex -ierve pesses from beneath the teres minor gained knowledge by using it for the decoy of what 'Tago mbile lthere is often' a painful hre' which requires would call " snipes." The fact that such men exist;P not special attention. Another' part of the region of the only a disgrace to the profession of' which 'they 'are shoulder where a painful area is encountered is over the members and a danger to the public, who are deluded by place where the suprascapular nerve reaches the dorsum' their pretensions, but a direct incentiive and encourage- otfthe scapula. In this connexion it must be noted that in' ment to the practice of medicine by people who have no an inflammation of a joint there must always be taken into knowledge, and equally little scrupie, in trading on the conbsideration the assobia ed condition of contraction of the ignorance of their dupes. It must be admited, further, muscular struettires round the joint. It. is this tension of. tbat there are large numbers of perfectly honest and the3muscles which eatzs the patient to complain of the honourable doctors who countenance, perhaps without feeling of heaviness of the arm in the affections' of the' full^yrealizing wha they are doing, the use of' secret and shoulder-joint under discussion. proprietary remedies. As long as such things are pre- In the cases of injuries to the shoulder-joint the deltoid scribed by orthodox practitioners it is vain to hope that muscle is especially liable to damage, and the paralysis they will be suppressed. Leaving this point for the which often results is not a difficult matter to recognize present, we will-confine ourselves-to the-practitioner who because the shoulder becomes flattened and the acromial comes within the scepe 'dJohnson's second definition-m process of the-scapula makes itself more evident.' In that is. to the " vain boastfal pretender to physick." those caEes in which the deltoid has been injured and Cause8 of Quackery. paralysis has supervened, the' practitioner must bear in Quackery has its root in the self-conceit which is one mind that the deltoid has slight recuperative power, and a of the ingredients that go to the making of " this foolish- guarded prognosis mnust be given as to the time it will take aompounded clay,' man." Hence, though every sort and for satisfactoty movement of the arm to occur. It is par. condition of men, and especially of women, is prone to pay ticularly in the case of the deltoid that the concurrent worship to the false gods of quackery, it is more common affection of joint and muscle can be demonstrated, because as a rule, in religious sects in which authority is most the circumflex nerve with others supplies both joint and ignored, and the right of private judgement is pushed to muscle in this case, and, as already described, the the furthest extreme. It is obvious that a man who adhesions which occur must' be broken down before a to satisfactory treatment of the condition can be effected. professes understand and expound the Scriptures by the In the dase of patients who are no longer young, and in light, of nature, will a fortiori think that he requires no whom wasting -of the deltoid has occurred, it is useful to guide to the perfect comprehension of the mysteries of the remember also 'that it may be a matter of months before human body. Professor Osler says: the miscle be restored to a condition of I suppose as a body olergymen are better educated than any catm activity. other, Iet they are. notorious supporters of all -the nostrums and (To be continued.) humbuggery with which the daljy and religious papers abound,i. and I find that the farther away they have wandered from the TMEE Royal Dental Hospital, Leicester Square, has decrees of the Council of Trent, the more apt' they are to be. received a donation of £500 from the trustees of Smith's steeped in thaumaturgic and Galenical superstition.* (Kensington Estate) Charity.. AMONGK those recently elected. Fellows of the Royal We have, of course, nothing to do with theologi¢al cveeis Saitary Institute are Major William Wz Clemesba, I.Ml.S., or churcese. It ie, ,therefore,i only by way, of illustraftg, Dr. Edward Sergeant, M.O,'H., Lancashire.i and D;>. R. P.. * Address on T!eachingand Thinking. Aequanimitt8.' SeCOnD3 edtl&^ Williams, Assistant M.O.E., Shefileld. LFondon. 1906. P. 131. r THI nBrrxIs r MAY 27, Ii9i , ,] QUACKERY IN THE PAST. I ZIXDICAL JOURNAL I25r =- Dr. Osler's statement that we refer to the fact that and told him of ib. Gonelle wrote his name on his tablete, quack advertisements flourish in ranker luxuriance in pretending also to make a note of the recipe. The whole religious papers which are the representatives of Noncon- length of the street he met no one who did not tell formist sects than in the Anglican or Roman Catholic him some cure or other, all different from the rest, papers.